Skip directly to site content Skip directly to search


Español  Other Languages


Centers for Disease Control and Prevention. CDC twenty four seven. Saving Lives, Protecting People
 Search

		Submit


Typhoid Fever and Paratyphoid Fever








National Typhoid and Paratyphoid Fever Surveillance Annual Summary, 2017										Related Pages
										Surveillance
Jurisdictions1 reporting at least one typhoid or paratyphoid fever2,3 case to the NTPFS during 2017 are shown in Figures 1 and 2.
**402** typhoid fever cases were reported by 39 jurisdictions (Figure 1).
**63** paratyphoid fever cases were reported by 21 jurisdictions; 62 were caused by *Salmonella* serotype Paratyphi A, 1 by Paratyphi C (Figure 2).1Includes all 50 states and District of Columbia.2Paratyphoid fever is caused by *Salmonella* serotypes Paratyphi A, Paratyphi B, and Paratyphi C. Two distinct pathotypes of Paratyphi B are recognized; one is associated with paratyphoid fever and the other is associated with uncomplicated gastroenteritis. The two pathotypes have distinct virulence characteristics and are differentiated based on the ability to ferment tartrate. The paratyphoidal pathotype is unable to ferment tartrate and is designated serotype Paratyphi B; the nonparatyphoidal pathotype ferments tartrate and is designated serotype Paratyphi B var. L(+) tartrate+. Only those isolates laboratory-confirmed as not able to ferment tartrate are included in the annual summary. Many Paratyphi B reports do not include this information; these reports are therefore excluded from this annual summary.3One case of paratyphoid fever caused by *Salmonella* serotype Paratyphi C was reported.On This Page
			SurveillanceDemographic and Clinical CharacteristicsInternational TravelTyphoid Fever VaccineNational Notifiable Diseases Surveillance SystemAntimicrobial ResistanceOutbreaks
		
Read an overview of theNational Typhoid and Paratyphoid Fever Surveillance (NTPFS) system [PDF – 2 pages]Figure 1Figure 2Typhoid fever cases reported to NTPFS, by jurisdiction, 2017 (n = 402)Download Data [XLS – 463 B]Paratyphoid fever cases reported to NTPFS, by jurisdiction, 2017 (n=63)Download Data [XLS – 463 B]Demographic and Clinical Characteristics of Patients
Demographic and clinical characteristics of patients with typhoid fever and paratyphoid fever are shown in Tables 1 and 2.
The median age of patients with typhoid fever was **25 years** (range 0 – 87 years).
The median age of patients with paratyphoid fever was **27 years** (range 2 – 76 years).
There were **two deaths** among patients with typhoid fever. There was **one death** among patients with paratyphoid fever.**Table 1**Demographic and clinical characteristics of patients with typhoid fever reported to NTPFS, 2017 (n =402)
	Demographic and clinical characteristics of patients with typhoid fever reported to NTPFS, 2017 (n =402)
**Characteristic (number with data available)**
**Number**
**Percent****Age group, years (n = 401)**
<1
2
<11–4
48
125–14
96
2315–24
54
1325–44
133
3345–64
57
1465+
15
4Female (n = 401)
174
43Food handler (n = 287)
6
2Outbreak-associated (n = 330)
23
7International travel1 (n = 398)
339
85Vaccinated2 (n = 264)
11
4**Specimen source (n = 396)**Blood
327
83Stool
60
15Other
9
2Hospitalizations3 (n = 399)
326
82Deaths (n = 373)
2
<11Travel destinations are shown in Table 3a.2Received typhoid fever vaccination within five years before illness began. Of the 11 cases in vaccinated persons, one received only the Vi capsular polysaccharide vaccine (ViCPS); vaccine type was not reported for the other ten.3Median length of hospitalization was five days.**Table 2**Demographic and clinical characteristics of patients with paratyphoid fever reported to NTPFS, 2017 (n = 63)
	Reported demographic and clinical characteristics of patients with paratyphoid fever
**Characteristic (number with data available)**
**Number**
**Percent****Age group, years (n = 63)**
<1
0
01–4
3
55–14
16
2515–24
11
1725–44
21
3345–64
7
1165+
5
8Female (n = 63)
29
46Food handler (n = 36)
0
0Outbreak-associated (n = 51)
3
6International travel1 (n = 58)
54
93**Specimen source (n = 62)**Blood
53
85Stool
5
8Other
4
6Hospitalizations2 (n = 63)
50
79Deaths (n = 56)
1
21Travel destinations are shown in Table 3b.2Median length of hospitalization was five days.International Travel
Among the 398 typhoid fever patients whose travel histories were reported, **339 (85%)** reported traveling or living outside the United States in the 30 days before illness began.
Among the 58 paratyphoid fever patients whose travel histories were reported, **54 (93%)** reported traveling or living outside the United States in the 30 days before illness began.
Among patients reporting international travel, **310 (91%)** patients with typhoid fever and **51 (94%)**patients with paratyphoid fever reported travel to a single destination (Tables 3a and 3b).
Visiting friends or relatives was the most common reason for international travel among patients with typhoid fever **(45%)** and paratyphoid fever **(55%).****Table 3a**Travel destinations for patients with typhoid fever who reported a single destination country, NTPFS, 2017
	Travel destinations for patients with typhoid fever who reported a single destination country, NTPFS, 2017
**Travel Destination**
**No. (%)**India
181 (58)Pakistan
33 (11)Bangladesh
32 (10)Mexico
24 (8)Haiti
6 (2)Other1
34 (11)1Nigeria (6), El Salvador (4), Guatemala (3), Burundi (2), Dominican Republic (2), Indonesia (2), Philippines (2), Afghanistan (1), Ghana (1), Iran (1), Iraq (1), Kenya (1), Mali (1), Marshall Islands (1), Morocco (1), Nepal (1), Samoa (1), Tonga (1), Uganda (1), United Arab Emirates (1)**Table 3b**Travel destinations for patients with paratyphoid fever who reported a single destination country, NTPFS, 2017
	Travel destinations for patients with paratyphoid fever who reported a single destination country, NTPFS, 2017
**Travel Destination**
**No. (%)**India
29 (57)Pakistan
12 (24)Bangladesh
6 (12)Indonesia
1 (2)Mali
1 (2)Other1
2 (4)1Nigeria (1), Senegal (1)Typhoid Fever VaccineFigure 3. Percentage of patients with typhoid fever (n =264) who reported receiving a typhoid fever vaccine in the five years before illness began, NTPFS, by year, 2013–20171
	Download Data [XLS – 67 B]1Figure excludes patients whose typhoid vaccination status was unknown or not reported (n=138).National Notifiable Diseases Surveillance System
The National Notifiable Diseases Surveillance System (NNDSS) collects and compiles reports of nationally notifiable infectious diseases, including typhoid fever. NNDSS reports can be found at www.cdc.gov/nndss/data-statistics.
The figure below presents a comparison of typhoid fever reports submitted to NTPFS and NNDSS in the past five years. Reports submitted to NNDSS can include clinically compatible cases that are epidemiologically linked to a confirmed case but are not laboratory-confirmed.
Comparisons for paratyphoid fever are not provided because, although it was nationally notifiable, it was reported under the case definition for salmonellosis during these years.Figure 4. Number of typhoid fever cases reported to the National Notifiable Diseases Surveillance System (NNDSS) and to the National Typhoid and Paratyphoid Fever Surveillance (NTPFS), by year, 2013–2017
	Download Data [XLS – 91 B]Antimicrobial Resistance
The National Antimicrobial Resistance Monitoring System (NARMS) monitors antimicrobial resistance among enteric bacteria, including *Salmonella* serotypes Typhi and Paratyphi A, Paratyphi B (tartrate negative), and Paratyphi C. Decreased susceptibility to ciprofloxacin (DSC, defined as minimum inhibitory concentration ≥0.12 μg/mL) has been associated with fluoroquinolone treatment failure among patients with Typhi infections in published literature. Multidrug-resistant (MDR) is defined as resistance to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole.
Among *Salmonella* serotype Typhi isolates obtained from patients during 2017:
**73%** had DSC
**10%** were MDR
**11%** were resistant to three or more classes of antibiotics
No isolates were resistant to ceftriaxoneAmong *Salmonella* serotype Paratyphi A isolates obtained from patients during 2017:
**86%** had DSC
No isolates were MDR
No isolates were resistant to three or more classes of antibiotics
No isolates were resistant to ceftriaxoneData are available in NARMS Now, an interactive tool containing antibiotic resistance data from bacteria isolated from humans.
Outbreaks
The Foodborne Disease Outbreak Surveillance System (FDOSS) collects reports of foodborne disease outbreaks from local, state, tribal, and territorial public health agencies. The most recently published annual reports are available at www.cdc.gov/fdoss/annual-reports.
The Waterborne Disease and Outbreak Surveillance System (WBDOSS) collects reports of waterborne disease outbreaks associated with drinking water and recreational water from local, state, tribal, and territorial public health agencies. Reports are available at http://www.cdc.gov/healthywater/surveillance/surveillance-reports.html.
**One outbreak** of typhoid fever (none of paratyphoid fever) was reported in 2017. The outbreak occurred in Ohio and resulted in **17 laboratory-confirmed and 11 probable cases**.ReferencesCDC. National Antimicrobial Resistance Monitoring System (NARMS) Now: Human Data. Atlanta, Georgia: U.S. Department of Health and Human Services, CDC. https://wwwn.cdc.gov/narmsnow. Accessed 9/27/2022.Recommended CitationCenters for Disease Control and Prevention (CDC). National Typhoid and Paratyphoid Fever Surveillance Annual Report, 2017. Atlanta, Georgia: US Department of Health and Human Services, CDC, 2022.Top of Page
							
					
							Last Reviewed:  February 14, 2023						Source: 	Centers for Disease Control and Prevention
, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)
, Division of Foodborne, Waterborne, and Environmental Diseases (DFWED)
					Facebook
        Twitter
        LinkedIn
        Syndicate homeTyphoid Fever and Paratyphoid Fever
Questions & Answers
Prevention
Symptoms & Treatment
Vaccination
For Healthcare Professionals
Surveillance
Resources & Publications


About CDC
					Contact Us
					800-232-4636
 Facebook Twitter Instagram LinkedIn Youtube Pinterest Snapchat
 CONTACT CDC
				Contact Us
							Call 800-232-4636
							Email Us
			ABOUT CDC
				About CDC
							Jobs
							Funding
			POLICIES
				Accessibility
							External Links
							Privacy
							Policies
							No Fear Act
							FOIA
							OIG
							Nondiscrimination
							Vulnerability Disclosure Policy
			CONNECT WITH US
				Facebook
								Twitter
								Instagram
								LinkedIn
							Youtube
								Pinterest
								Snapchat
								Email
			LANGUAGES
				Español
							繁體中文
							Tiếng Việt
							한국어
							Tagalog
							Русский
							العربية
							Kreyòl Ayisyen
							Français
							Polski
							Português
							Italiano
							Deutsch
							日本語
							فارسی
							English


U.S. Department of Health & Human Services
			Accessibility
			External Links
			Privacy
			Policies
			No Fear Act
			FOIA
			Nondiscrimination
			OIG
			Vulnerability Disclosure Policy
			USA.gov


Exit Notification / Disclaimer Policy Close
 Links with this icon  indicate that you are leaving the CDC website. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
				Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
				You will be subject to the destination website's privacy policy when you follow the link.
				CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Website Disclaimers
 Cancel Continue